oneilltalk

Since we got onto the subject of cerumen, here are a few thoughts...

Based on my extensive experience with cleaning out ears of all ages and shapes.

  First Challenge   

Protecting one's ear(s).

That's easy.

The guiding maxim is: "Never put anything in your ear besides your elbow."

Try it. You'll quickly understand its wisdom.

  Is there a cerumen buildup or not?  

Again. The question gets right to the point.

In the old days of ear care, someone else had to have a look.

Such an observer used an otoscope, put a clean plastic speculum on it, and had a look.

If one wanted to make an auto-assessment of the external ear canal's state,

many took a Q-tip, ran it around without causing to much ear pain,

and checked the tip of the tip, to see if it had brown shiny goo stuck to it or not. 

If yes, that still left one faced with the next question. 

Is there still more goo left in my ear?

And in the past, many stayed stuck at that level of ear care.

But today, thanks as for so many things to the Chinese, (some good, some less so),

you can just have a look in your own ear. Several times a day if you really get into this.

'How to' instructions ...

• • • Buy a cheap ear endoscope. It's a camera with a fiberoptic light bundle.
    • On AliExpress.com 14€, or the same thing on Amazon. com (79.99 $US). Here is the 8.99$US version on Amazon. That one comes with enough fiberoptic cord to retrieve jewelry from sink drains.
    • It hooks up via Bluetooth or its cable to your cellphone.
    • It provides a not stellar but adequate image of anything 1 to 3 cm away. (Other distances, and the images get fuzzy). This turns out to be just what is needed.
    • Once it arrives, read the unintelligible instructions then practice with it. The image in an endoscope is usually reversed and upside down. Practice reading some printed page to figure out which side of the thing is up. Turn that side towards the top of your head.
    • Don't forget to remove the translucent plasic cover from the tip of your new endoscope camera, or you won't see anything clearly. (Took me about 20 minutes to work through this problem on first use).
    • DO NOT, repeat, DO NOT even think about using the tiny loops and hoops and scrapers and "ear spoons" this device comes with to clean out your ear canal. Unless one has done a lot (>500 hours) of microscopic surgery, you are almost guaranteed to punch a hole (accompanied by exquisite pain) into and through your tympanic membrane (ear drum). DON'T DO IT. The camera by itself will not do this unless someone whacks the end of it with a tenneis racquet while you have it in your ear.
    • Cleaning of the ear canal is described immediately below.

  Cleaning Ear Wax  

1. 1. 1. 1. Get the right products at the pharmacy (or plan ahead and buy on Amazon)
            1. A little bottle of Ceruminex (like ENT's use) It's now called by other names (Debrox for instance). All are CARBAMIDE PEROXIDE.
            2. A bottle of hydrogen peroxide, 12% (food grade)
            3. A rubber bulb syringe like Moms bring home from the hospital for their babies. This can also be used to wash out the canal of a hearing-aid if MOLD or wax has plugged it up.
            4. An ear wash basin is a handy thing to catch all the liquid we are about to start spilling everywhere.
            5. A cotton ball.
            6.  A face towel. (No link provided. Assuming you have one).
         2. Now we're going to clean that ear canal ...
            1. Follow the instructions on the package, but put about 5 drops of carbamide peroxide in the ear canal while lying down, ear up (or it runs out). Stick a wad of cotton ball into the ear opening to keep it in place. Let it work for 10 or 15 minutes.
            2. Prepare about 2 coffee mugs worth of warm-ish, not hot, water that is 50:50 mixed with the hydrogen peroxide. Cold or hot water will make one dizzy (its actually a neurologic test to shoot cold water in the ear and see if the patient's pupils get big or not).
            3. After 10 or 15 minutes, go stand next to a sink. Fill the rubber bulb syringe with the (now 6%) warmish hydrogen peroxide solution.
            4. Place the basin under your ear against your neck, and begin squirting the 6% hydrogen peroxide solution into your ear canal. The peroxide will start making a crackling sound which is normal in this setting.
            5. Do not be afraid to be generous and vigorous with the bulb syringe. Else, it just won't get the stuff out. You can declare success when the ear basin has disgusting brown junk floating in it. Do both mugs of the warmish H2O/ H2O2 mix. Don't be too gentle with this step. But also, don't use the garden hose.
            6. Once presumeably done, you can check the ear canal with the new handy ear endoscope. If still not clean, believe it or not, go back to step number 1. Usually not necessary unless last ear cleaning was greater than 10 years ago.
            7. Anticipate that all this gentle trauma will make the tympanic membrane swell a bit, and reduce hearing for 30 to 60 minutes.
            8. Once successful, can gently swab out moisture from ear canal with a Q-tip.
            9. If wearing a hearing appliance, recheck to make sure that its canal isn't plugged, rather than yours.

  Testimonials & Anecdotes  

• • • • • I have done this with many of my surgical patients in the past. They were eternally grateful. While there was an ICD-9 procedural code for it, insurance never reimbursed. I lived off the grateful thanks of the patients.
        • I did this with cousin Georges Wetz about every other month with quite productive yields of cerumen. I never quantified this further by weighing the effluent.
        • I did this every month with Leon M. Wetz who seemed to enjoy it immensely.
        • I did this a time or two with B.M. O'Neill who tolerated it while complaining and yelling and swearing in Walloon throughout the procedure.
        • I have have never done this personally, because my production levels of cerumen seem rather paltry. I do use my ear endoscope to check out my ear canals about 4 times/ yr, invariably with reassuring results.

  Here is What Ear Endoscopy Looks Like   

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That question requires a bit more explanation.

It also needs to be couched in a setting of some individuals with runny noses, and others with clogged Eustacian tubes contributing to hearing loss.

One can readily imagine the respiratory pleasures of being on an island.

Gentle breezes have been traveling thousands of miles over the ocean.

These movements of air have been picking up a level of humidity that is perfect for our pulmonary system.

In addition to the right relative humidity, these gentle breezes carry useful amounts of salts, as well as negative ions.

Let's set aside for the moment further discussion on negative ions.

But on the island of Bermuda today, is that ideal though invisible mix, what a person is breathing during most of the hours awake and asleep?

The time asleep is particularly important at this season of the year, since with less light in this hemisphere, humans tend to display a pseudo-hibernation and sleep a few more hours than usual. This clearly relates to levels of secretion of melatonin by the pineal gland, and seasonal variation in these levels.

Let's set aside for the moment further discussion on the pineal gland.

Coming back to our question, what are you breathing?

Are you breathing the gentle, health sustaining breezes just described?

Or, is what is entering the respiratory tract with each breath, a quite different air?

Here is a simple question.

Who is controlling, and using what system, the air you breathe?

This becomes much more important when one considers the number of hours of relatively passive breathing while sleeping.

What is the relative humidity of this inspired air? What should it be?

Here is a link that addresses that, and from which I quote:

“The best relative humidity for sleeping and other indoor activities has been debated. According to the Environmental Protection Agency, the best indoor relative humidity falls between 30% and 50%, and it should never exceed 60%. Other studies suggest 40% to 60% is a better range. Regardless, 60% seems to be the agreed-upon threshold for indoor humidity.

Conversely, exposure to excessively low humidity levels can cause health problems such as dry skin, itchy eyes, and a sore throat. Low humidity has also been linked to respiratory infection.”

So, how would one know?

By measuring the relative humidity near where one is sleeping or spending the majority of one’s hours.

Here is a nice choice that is readily available.

On December 29, what does the weather report for the island of Bermuda instruct?

This leads to the assumption that the heat is now on where you are staying.

Suddenly the current environmental conditions on Bermuda may contribute to a less than ideal setting for problem-free health.

Is the heat on?

Is it baseboard heat?

Radiators that need a good brushing out?

In spite of Bermuda’s typical 88% relative humidity throughout the year (which is quite high and favors mold formation), has implementation of a central heating system in fact reduced relative humidity levels far below that? Especially during hours of sleep?

Making measurements always reduces the amount of uncertainty and unknown in any such question. 

So, ... is mold an issue here?

How would you know?

Even if no visible (dark spots in shower or ceiling corners, or behind panels) mold is present, it can still be floating around in the air one is breathing. It can contribute to reactions that are essentially allergic.

Here is a kit that can be used to measure for mold in the air one breathes.

Hope this contributes to clearing the air and putting an end to runny noses and plugged ears.

At least its not roaches.

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